Organization
LAKE REGION UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM HASTINGS FORESMAN M.D. (PRESIDENT)
(315) 258-5253
Entity
Organization
Contact information
Practice address
192 GENESEE ST, AUBURN, NY 13021-3361
(315) 258-5253
(315) 258-0202
Mailing address
192 GENESEE ST, AUBURN, NY 13021-3361
(315) 258-5253
(315) 258-0202
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
195558
NY
Other
Enumeration date
02/10/2006
Last updated
06/19/2008
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